400% of Federal Poverty Level

This is the number you
really need to know going forward into the
Covered California changes. Are you under 400% of
the Federal Poverty Level for your estimated
current year's income? That lone fact will
dictate whether you receive sizable California
health insurance subsidies or whether you pay
much higher premiums.. We
are talking about billions of dollars flowing to
and from (through taxes) millions of people.
Let's check out the 400% Federal Poverty limits
and also really understand what's at stake.

Here
are the 2015 400% of Federal Poverty Levels:

Household

FPL

138%

150%

200%

250%

266%

400%

1

$11,770

$16,243

$17,655

$23,540

$29,425

$31,308

$47,080

2

$15,930

$15,930

$23,895

$31,860

$39,825

$42,374

$63,720

3

$20,090

$27,724

$30,135

$40,180

$50,225

$53,439

$80,360

4

$24,250

$33,465

$36,375

$48,500

$60,625

$64,505

$97,000

5

$28,410

$39,206

$42,615

$56,820

$71,025

$75,571

$113,640

6

$32,570

$44,947

$48,855

$65,140

$81,425

$86,636

$130,280

7

$36,730

$50,687

$55,095

$73,460

$91,825

$97,702

$146,920

8

$40,890

$56,428

$61,335

$81,780

$102,225

$108,767

$163,560

We specifically
built the grid to reflect the important jump
points that affect plan options and costs.
Let's look at each and why they matter.

FPL. This
is the Federal Poverty Level for the 50 core
States and most importantly to us,
California. All the the important numbers
are multiples of this key rate.

138%.
This is the California adjusted number which
acts as a dividing line between Medi-cal
eligibility and the standard plans for
adults 19 and over. Below this amount,
adults will likely be eligible for Medi-cal.
Above this amount but below 400%, you will
likely be eligible for a standard plan or
Enhanced Silver plan and some tax credit.

138% - 150%
Adult eligibility for the Silver 94 plan.
This is the richest plan on the market.
These people will be eligible for the
richest tax credit (which decreases on a
sliding scale until 400%). Children under
19 eligible for Medi-cal.

150% - 200%
Adult eligibility for the Silver 87 plan.
Children under 19 eligible for Medi-cal.

The tax credit
is on a sliding scale from 138% to 400%.
There are situations where income is under
400% but there is no tax credit. This
typically occurs for younger adults with
income in the higher range (but under
400%).

These numbers
are specific to California since Covered Ca
adjusted certain benchmarks to make them
richer than the ACA law requirement.

It's best to
look at a person's particular income,
household, and health care need situation.
We can quickly evaluate how much tax credit
you might eligible for and evaluate the plan
options.

Call us at
800-320-6269 to find out what you are
eligible for specifically.

Why
400% of the Federal Poverty Level?

The ACA bill sets 400% of
the FPL as the dividing line between those that
will qualify for a subsidy and those that will
not. If your MAGI (Modified Adjusted Gross
Income...think both active and passive income)
is under 400% of the the FPL number, you may
qualify for subsidy. The subsidy is based on
keeping your share of health insurance premium
below a certain amount (9.5% at the most) of
your income. For example, if you make 350% of
the FPL and your premium is $1000 with an income
of $3,000 monthly, you may receive a subsidy of
approximately $700. Your net premium in this
simplified example would be $300/monthly of the
original $1000. We'll provide a
calculator at the bottom of this article.

What if you
make over 400% of the FPL?

You receive no subsidy.
It's a very steep line...there is no gradual
scale but a drop off and those making over 400%
of poverty can expect health insurance premiums
to be quite a bit more expensive. This is why
the 400% rate is so important. It's literally
the difference between $1000 of dollars in
health subsidies versus none. We expect to have
two distinct camps of health care
shoppers...those with a subsidy (pleased) and
those without (irate). It's going to be an
interesting 12 months in the California health
insurance market!

Settlement of
subsidies received

If your income goes up
significantly during the year that you are
receiving the health subsidy, you may have to
pay back part of the advanced subsidy as part of
your tax filing in the following year. the
amount to be paid back is based on your % of FPL
and the amount you received. People who still
make under a certain level will not need to pay
back the full amount they had received.

We can quickly size up what income to look at, what
period to consider, and what makes up your household
so that you get the most tax credit possible.
Call us at 800-320-6269.

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